title: Compression stockings limit the incidence of postoperative lymphocele in kidney transplantation.
abstract: BACKGROUND
  Lymphoceles account for considerable morbidity rates after kidney transplantation. As yet, there is no therapeutic strategy to prevent the formation of lymphoceles. The lower limb provides a large reservoir for lymphatic tissue. Prophylactic compression therapy limits tissue volume and edema formation and may therefore reduce postoperative lymph flow.
  
  
  RESULTS
  In a non-randomized prospective study using a historical control group prior to 2006 as comparison from our center (2004-2008: total n=126), we found that lymphoceles are significantly diminished on the ipsilateral lower limb of the operative side when patients wear class II compression stockings (n=69) for four weeks after transplantation compared to patients achieving standard antithrombotic therapy by compression class I stockings (n=57) for thrombosis prophylaxis until full mobilization (33% versus 15%, p-value<0.05). Furthermore, a significantly lower percentage of patients needed surgical treatment of the lymphoceles for obstructive complications after class II compression (4% versus 18%, p-value<0.01). These findings were independent of the recipients' demographics, the duration of the surgical procedure, and the operating surgeon.
  
  
  CONCLUSIONS
  Further studies are needed to demonstrate the usefulness of compressing stockings for the reduction of lymphoceles after kidney transplantation. This approach would not only reduce post-transplantation morbidity, but also provide an easy and cost-effective treatment without side-effects.
authors.affiliation: Department of Surgery, Mannheim University Medical Center, Heidelberg University, Mannheim, Germany. kai.nowak@umm.de
authors.forename: Kai
authors.initials: K
authors.lastname: Nowak
authors.forename: Roderich
authors.initials: R
authors.lastname: Bönninghoff
authors.forename: Michael
authors.initials: M
authors.lastname: Geiger
authors.forename: Stefan
authors.initials: S
authors.lastname: Post
authors.forename: Peter
authors.initials: P
authors.lastname: Schnülle
authors.forename: Mathias
authors.initials: M
authors.lastname: Schwarzbach
mesh_terms: D000328:Adult; D000368:Aged; D006801:Humans; D015994:Incidence; D016030:Kidney Transplantation / Q000009:adverse effects*; D008210:Lymphocele / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control* / Q000601:surgery; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control* / Q000601:surgery; D012189:Retrospective Studies; D053828:Stockings, Compression; D014019:Tissue Donors; D055815:Young Adult
keywords: Kidney transplantation; complication; lymphocele; retrospective trial